Low Levels of Neutrophils

Low levels of neutrophils, also known as neutropenia, can be a serious ailment that affects the body's ability to fight off infections. This happens when the number of neutrophils, a type of white blood cell, drops below normal levels in the bloodstream.

Understanding what Low levels of neutrophils mean is essential for managing one's health effectively. Low-level neutrophils can make a person more susceptible to infections and illnesses. Let's explore the low neutrophils causes, symptoms, and treatment approaches for the same. It will also discuss when to see a doctor and how to prevent this condition from occurring or worsening.

What are Neutrophils?

Neutrophils are an essential element of the immune system, which protects the body against infections. These white blood cells, known as polymorphonuclear leukocytes (PMNs), are the most ample type of immune cells in the bloodstream. They make up 50% to 75% of all white blood cells, highlighting their significance in maintaining overall health.

The primary function of neutrophils is to act as the body's first line of defence against invading pathogens. When bacteria, fungi, or other harmful microorganisms enter the body, neutrophils are among the first immune cells to respond. They quickly travel to the site of infection, where they capture and destroy these invaders through various mechanisms.

When neutrophils are low, a condition known as neutropenia, the body's ability to fight infections is significantly compromised. This can make people more susceptible to various illnesses and complications. 

Symptoms of Low Levels of Neutrophils

The symptoms of neutrophils can vary from person to person, and not everyone will have the same signs. Some common indicators of neutropenia include:

• Fever: This is often the first sign of an infection in people with low neutrophils. It's sometimes referred to as febrile neutropenia.
• Extreme Tiredness (Fatigue): Individuals may feel unusually tired or weak due to infection
• Recurring or Persistent Infections: Infections that last for a long time or keep coming back can be a sign of Low levels of neutrophils.
• Sore Throat (Pharyngitis): This can be a common symptom due to increased susceptibility to infections.
• Mouth Ulcers: Painful sores in the mouth, also known as mucositis, may develop.
• Loss of Appetite: Some people may experience a reduced desire to eat.
• Swollen Lymph Nodes: This can signify that the body is fighting an infection.
• Diarrhoea: Gastrointestinal issues may occur due to infections.
• Urinary Symptoms: These can include a burning sensation during urination, urgency, or increased frequency.

Causes of Low Levels of Neutrophils

Low levels of neutrophils, also known as neutropenia, can occur due to various reasons. 

• Genetic Conditions: Some people are born with inherited disorders that impact the production or function of neutrophils, such as benign ethnic neutropenia (BEN), cyclic neutropenia, and severe congenital neutropenia.
• Infections: Bacterial, viral, and parasitic infections like HIV, hepatitis, tuberculosis, and sepsis can cause a decrease in neutrophil count. 
• Cancer and Related Treatments: Blood cancers like leukaemia and lymphoma can affect the bone marrow's ability to produce healthy white blood cells, including neutrophils. Additionally, cancer treatment modalities such as chemotherapy and radiation therapy can harm or destroy neutrophils and the bone marrow that produces them.
• Medications: These include some antibiotics, antipsychotic medications, and drugs used to treat overactive thyroid.
• Nutritional Deficiencies: Insufficient intake of essential vitamins & minerals like vitamin B12, folate, or copper in the diet can lead to decreased neutrophil production.
• Autoimmune Conditions: Lupus, rheumatoid arthritis, and Crohn's disease can cause Low levels of neutrophils. The body's immune system inadvertently attacks & destroys healthy neutrophils in these cases.
• Chronic Idiopathic Neutropenia: It is a specific type of low-level neutrophil that has no apparent cause. 

Diagnosis

To confirm neutropenia, doctors rely on specific tests and examinations.

• Complete Blood Count (CBC) or Full Blood Count (FBC): This test measures the number of each type of blood cell, including neutrophils. 
• Bone Marrow Examination: If initial blood tests indicate Low levels of neutrophils, the next step in diagnosis is often a bone marrow examination. There are two methods of examining bone marrow. The first is bone marrow aspirate, where marrow cells are extracted like a blood sample. The second is a bone marrow biopsy, which involves taking a small piece of the solid, bonier part of the marrow to study its structure.
• Neutrophil Antibody Testing: It can help exclude autoimmune neutropenia. 
• Cytogenetic Studies: They are conducted to examine the hereditary properties of cells and chromosomes, as any structural abnormalities in marrow cells may be preceded by cytogenetic changes.

Treatment

The treatment for low levels of neutrophils depends on the underlying issue and severity of the condition. It includes:

• Antibiotics: When a person with Low levels of neutrophils develops a fever, doctors often prescribe antibiotics as a precautionary measure. 
• Granulocyte Colony-stimulating Factor (G-CSF): This treatment stimulates the bone marrow to produce more WBCs, including neutrophils. G-CSF benefits various types of neutropenia, including those caused by chemotherapy. 
• Chemotherapy: It is useful if neutropenia is due to malignancy in bone marrow.
• Changing Medications: If certain drugs are causing low levels of neutrophils, updating the medication regimen can help address the issue. 
• Corticosteroids: Doctors may prescribe corticosteroids for individuals with autoimmune conditions to reduce the body's immune response and prevent it from attacking neutrophils.
• Stem Cell Transplants: Doctors may consider stem cell transplants a treatment option for some types of severe neutropenia, particularly those caused by bone marrow problems.

When to See a Doctor

If you have Low levels of neutrophils, it's crucial to be vigilant about your health and seek medical attention promptly when necessary. Visit to a doctor if:

• Your temperature rises to 100.4 degrees Fahrenheit (38 degrees Celsius) or higher for more than an hour
• You have a temperature below 98.6 degrees Fahrenheit 
• You have chills, body aches, extreme fatigue, sore throat, mouth sores, or a new or worsening cough
• You experience gastrointestinal symptoms such as diarrhoea, vomiting, abdominal pain or urinary symptoms, including burning or pain during urination, increased frequency, or dark urine.
• You have unusual vaginal discharge or irritation. 
• You experience changes in mental status, like confusion or sudden forgetfulness, pale skin, chest pain, fast heartbeat, or shortness of breath. 

Prevention

While some types of neutropenia cannot be prevented, there are several strategies to minimise the risk and manage the condition effectively.

• For individuals undergoing chemotherapy, doctors may adjust treatment plans to prevent low levels of neutrophils. This could involve delaying the next round of chemotherapy or reducing the dose. Doctors may sometimes suggest granulocyte colony-stimulating factor (G-CSF) injections to boost white blood cell production, increasing neutrophils.
• Good hygiene practices are vital in preventing infections when neutrophil levels are low. Regular handwashing with soap & water or using an alcohol-based hand sanitiser is essential. 
• Avoid coming in contact with sick people and crowded places can help diminish the risk of exposure to harmful pathogens. 
• Proper food handling and preparation are essential. This includes washing fruits & vegetables thoroughly, keeping raw meats apart from other food items, and cooking meals to the appropriate temperature. Avoiding unpasteurised dairy products and undercooked meats is also advisable.
• Preventing injuries and promptly treating any cuts or scrapes is also crucial.
• By following these preventive measures, individuals with Low levels of neutrophils can significantly reduce their risk of infections and maintain better overall health.

FAQs

1. What are normal neutrophil levels?

Normal neutrophil levels typically range between 2,500 and 7,000 neutrophils per microlitre of blood. 

2. Who is affected by neutropenia?

Neutropenia can affect people of all ages. It's common in cancer patients undergoing chemotherapy, with about 50% of them developing low levels of neutrophils. Children under two years old may experience primary autoimmune neutropenia. Some ethnic groups, such as those of African, Middle Eastern, and West Indian descent, may have a condition called benign ethnic neutropenia.

3. How does neutropenia affect my body?

When Low levels of neutrophils mean your immune system is weakened, your body finds it more challenging to fight off infections. This makes you more vulnerable to bacterial and fungal infections. 

4. What does it mean if your neutrophils are low?

Low neutrophil levels indicate your body's ability to fight infections has decreased. The lower your neutrophil count, the higher your risk of infection.

5. Is low neutrophils curable?

The treatment for low levels of neutrophils depends on the cause. Some types may not require treatment, while others can be managed with antibiotics, corticosteroids, or drugs that stimulate white blood cell production. Sometimes, addressing the underlying condition or adjusting medications can help restore normal neutrophil levels.

6. What should I eat if I have low neutrophils?

Focus on eating a varied diet with proper food safety practices. Avoid unpasteurized dairy products, raw or undercooked meats, and unwashed fruits and vegetables. 

7. How can I increase my neutrophils naturally?

To support your body's neutrophil production, ensure you get adequate nutrients, especially vitamin B12 and folate. However, the underlying cause needs to be addressed. 

Dr. Kunal Chhattani

CARE Medical Team